How to move the needle on wellness

When it comes to preserving health and prolonging life, study after study shows that prevention is essential. From type 2 diabetes to early-stage prostate cancer, clinical trials have demonstrated that countless diseases can be avoided or even reversed through (often simple) lifestyle changes. We know the solution. Yet the challenge is reaching it. For example, tens of millions of overweight Americans are dieting at any given moment, but only a small percentage of these individuals lose weight and keep it off.

The explanation, borne out by research, is intuitive: While providing patients with information is important, this isn’t what motivates people to make lasting changes and adhere to them. Rather, it’s a sense of community. There’s an innate human understanding that anything that can connect us is really healing. Indeed, if you look at the inverse, studies show that people who report feeling lonely or isolated are ten times more likely to die prematurely.

So what can we do as physicians to help move this needle closer to wellness?

The palliative-centric model has proven unsatisfying for both doctors and patients, yet there are challenges to creating a new paradigm. For overworked physicians, time is an increasingly precious resource. Many of us are lucky to get a long enough visit with a patient when he or she walks into our office; while the will may be there, there is simply no way we can give each individual the kind of consistent, day-to-day support he or she may need to make long-term lifestyle changes.

Yet even in that brief window we do get, there are some steps we can take. We can, for example, help our patients map out who will be part of their day-to-day support network. We can ask, for example, whether they have family or friends nearby who can help support their wellness goals.

Further, data shows that our health patterns tend to mimic those of our peers; obesity is contagious insofar as we are more likely to overeat if our friends do. But by that token, wellness can be viral, too, and we can ask our patients if they know anyone within a five-mile radius of their home with whom they can make a regular walking date.

The answers to simple questions like these give us insight into how much social support our patients already have access to, and that can help us prescribe further support tools. There’s no question, for instance, that trackers and apps can be a useful adjunct for many people. If we take a little time to familiarize ourselves with what’s out there, we can help guide patients to the technologies best suited to their needs. High on this list should be the ones that offer ways for people not just to connect with an accountability tool, but also with each other.

We can also, of course, recommend resources and programs within our communities. From hospitals and community centers to gyms and even retail outlets, wellness programs abound. Not only are many of them free, but also some may net patients prevention points from their insurance providers. For best outcomes, make sure that the programs you choose seem to offer participants a channel to talk openly and authentically without fear of being judged.

What’s most exciting, perhaps, is what’s ahead. As our reimbursement model moves increasingly toward prevention, it’s beginning to become sustainable for providers to create support groups and care teams for patients. A nutritionist-led diabetes group that meets in our office every Thursday evening, for instance, will not only deepen our patients’ knowledge of their condition, it will also do what’s needed most – offer them support and community in managing their condition.

To date, so much of our society’s approach to health has been fear-based, and we’re seeing that this is not really sustainable in the long run. Fortifying wellness with encouragement and empathy is what, I believe, will cross us over from sick care to true health care.

Physician Coaching by KevinMD

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Eric Strong

“From type 2 diabetes to early-stage prostate cancer, clinical trials have demonstrated that countless diseases can be avoided or even reversed through (often simple) lifestyle changes.”

Really? You may have had a better argument supporting your thesis if you didn’t open with this ridiculousness. Type 2 diabetes avoided or reversed with lifestyle changes? Sure, in some people.

Prostate cancer, on the other hand, has mixed data as to the impact on risk of diet and other lifestyle factors. And for the record, these are almost solely observational studies, which aren’t “clinical trials”. There is no evidence that employing lifestyle changes in a patient with a baseline unhealthy habit has any impact on prostate cancer risk. And finally, to state that prostate cancer can be “reversed” through lifestyle changes is complete nonsense.

This is why so many doctors discount the opinions of their wellness-focused colleagues who believe a “healthy” diet and regular exercise can make anyone live to 100. They mix truth with speculation and occasionally outright fabrications, damaging their credibility to the point where they cannot be trusted to educate the public about these important issues.